Our Interview with Diabetes UK Chief Executive Chris Askew

By Alexander Wolf and Varun Iyengar

Every year, our team journeys “across the pond” to the United Kingdom, where we have the opportunity to attend the Diabetes UK Professional Conference. Diabetes UK – the largest diabetes charity in the UK – hosts the annual conference, bringing together healthcare providers and patients to discuss the latest updates in diabetes.

We are big fans of Diabetes UK’s work to “Care. Connect. Campaign.” across both type 1 and type 2 diabetes. This year, we had the chance to speak with its new CE, Mr. Christopher Askew, to learn more about the work Diabetes UK is most excited about moving forward.

See below for our full interview to learn more about the organization’s major initiatives, hopes for the future, and its plans to raise the national conversation on diabetes.

Interview with Diabetes UK CE Chris Askew

diaTribe: Thank you so much for taking the time to speak today. What are Diabetes UK’s main areas of focus?

Chris Askew: First, research is a very large part of what we do. We fund around seven million pounds [~$10 million] worth of research each year. And our approach to that has been something called response mode funding. We’ll put a general call for grants out, look at the applications that come back, and fund the best of those. And that tells me that we are funding the best people with the best ideas in diabetes research in this country.

I think as we look forward, we’re going to continue that. But we’ve also recently set up things called Clinical Studies Groups and Priority Setting Partnerships, which help us to increasingly host the discussion ourselves and ask if there any things in particular we think we should be researching … I think these Clinical Studies Groups may help us to understand the big themes and the big residual questions in research, whether it’s type 1 or type 2, immunotherapy or vaccinations, whether it’s in prevention and public health, or if it’s in treatments.

Our second major area of focus is making sure people with diabetes have the resources and information that support them on a day to day basis. Those can be things like online education assets, care-lines where people can call us for free and ask about anything, online forums, peer-to-peer groups, and physical groups in communities where people can go.

And the third area of focus, which is really important, is we work with the health systems across the four nations (Northern Ireland, Wales, Scotland, England). We work with diabetologists, endocrinologists, diabetes specialists, nurses, people with diabetes – to make sure the care and treatment they are receiving is as good as it should be and can be.

diaTribe: There seems to be some disparity in the standards of care across the four nations. Is that something Diabetes UK wants to do something about?

Chris Askew: Absolutely, we have a big disparity, and the reality is that this is really problematic. It quite simply means that if you’re in one part of the UK, you might be getting a very different level of service than if you’re in another part of the UK. We already know that some different groups fare worse. Type 1 tends to not get the same levels of care and support as type 2. Under 40s fare worse than over 40s. So we really need to understand more about this.

In this country, we have 15 key checks and services you should expect when you get your check-ups to make sure you’re well and healthy: things like A1c, blood pressure, kidney function, eye tests, etc. The numbers of people getting those tests range from something like 16% of people in the poorest performing areas, up to something like 30% in the best performing ones. So we’re still along way off from everyone doing really well, but that variance is a real problem, and we need to understand what’s underpinning that.

diaTribe: Fantastic, thanks so much. What is the overall budget for Diabetes UK in 2016?

Chris Askew: We turn over around 40 million pounds…And certainly, when you look at other conditions in the UK – cancer for example – we’re at a twelfth of the size of the largest cancer organization. And it’s not an issue of being large for the sake itself – I know there’s more we can do and we need more resources to support that.

diaTribe: We see the same thing in the US. If you look at what the NIH funds per patient in different disease areas – it’s thousands of dollars per patient with HIV, hundreds per patient for cancer, and only a few dollars per patient for diabetes.

Switching gears, what message do you have for people with diabetes about what they could do to help advocate on the national level to help solve the broader problem?

Chris Askew:  Come get involved with us! As volunteers, we have service champions – those are people who have got a strong view of the local service they got and work with us when we sit down with commissioners in that area to give their lived experiences as patients. We also have Diabetes Voices – those are volunteers that help us with our big national campaigns.

We have big campaigns all the time. This year we have a campaign on diabetes awareness in schools. We are running a campaign called Putting Feet First – which is really looking at those areas of the country where lower limb amputations rates are higher than the national average and engaging with those clinical teams to say, “Why is that the case and what can we be doing to lessen that? Those are preventable amputations.”

In these campaigns, we lean very heavily on Diabetes Voices – the real experiences of people with diabetes. They give us our moral authority – they give our campaigns real credibility, because they’re the true stories of people who have got those experiences.

diaTribe: Could you just talk a little about the public campaign work you plan to do in the future?

Chris Askew: I think that in the future we may want to think about how do we actually impress upon the British public the nature of diabetes. We did a small survey recently of a sample of people – a high degree of which actually had diabetes – just asking them to tell us what they were most fearful about in terms of illnesses and conditions. And I think cancer was up in the high 80% range, somewhere around 50-60% of this sample were worried about cardiovascular disease and heart attacks, but when we asked about diabetes, we were around 25%. So only 25% of those people were really fearful about diabetes and in some sense that’s good…but is there something in that low level of concern that masks a real understanding of the complications in diabetes?

So I think in terms of public campaigns and where we might go in the future, I think we might take our role in making sure the British public is aware of the seriousness and scale of diabetes – not for the purpose of spreading fear or unnerving people, but just so we can help the public have a truthful sense of the nature of diabetes.

diaTribe Have you ever faced any challenges in finding the balance between working in both type 1 and type 2 diabetes.

Chris Askew: Yes, for sure. An increasing part of our work is around the prevention of type 2 diabetes and what we can do to challenge the rise in type 2 diabetes incidence. And that’s a long way away from the work we do in type 1. And yes certainly, people will say, “You seem to be incredibly active in the public media in talking about risk factors in type 2 – it’d be good if you could do more of that for type 1.” And we take all of that feedback on board, and I think that at every opportunity we need to be clear, honest, open, and transparent about the work we are doing.

So for example, that seven million pounds I mentioned in research, it’s more or less split 50/50 between type 1 and type 2. That’s not something we proactively design, but the ratio works for us. It allows us to provide support to the sorts of projects that are out there, and I can’t see us shifting that. I wonder whether everybody knows that, and I think we may need to be clearer with our supporters about the services we deliver both in type 1 and type 2.

Mostly what I think people look to us to do – this is really important – is that when we speak to the media, we make sure we get the terminology right. We make sure that we are very clear whenever we can be to do what we can to break some of those myths around type 1 and type 2, and I do hope we do that.

diaTribe: What misconceptions do you think the general public has about people with diabetes?

Chris Askew: Oh they’re plentiful. The causes of diabetes for instance – that people may see having type 1 as being diet-initiated, when of course it has nothing to do with that. And it’s not just about myths, I think there is also some sense of blame in type 2 diabetes, which is entirely unhelpful…So again, I think we have an opportunity as the national charity that spans type 1 and type 2 to speak with truth and to speak honestly and openly, and to challenge those myths and misconceptions wherever they occur.

diaTribe: Thank you so much – it’s been great talking with you.

[Photo Credit: diabetes.org.uk, twitter.com/ChrisAskewCE]